Nootropics for Brain Health: Do They Really Do Anything?

Nootropics for Brain Health: Do They Really Do Anything?
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This article was medically reviewed by professor emerita of psychological and brain sciences Susan Krauss Whitbourne, PhD, a member of the Prevention Medical Review Board, on April 18, 2019.

More Americans than ever are focusing on improving their brain health by reducing stress and lowering their risk of Alzheimer's, so it's no surprise that the MIND diet took the fourth spot on U.S. News & World Report's best overall diets for 2019. But some people want to go beyond following a healthy diet and take supplements to enhance their mental performance. That's where nootropic supplements—aka smart drugs—come in.

Proponents of nootropics says that they can do everything from boost mood to increase creativity and brain power, so you not only feel good but have the energy and focus to be productive.

But what are these "smart drugs," anyway? Do they really offer any health benefits, and are they safe to take? We tapped some health experts about the nootropic craze and what they can do for you.

What are nootropics, exactly?

Nootropics are supplements and prescription drugs that are meant to optimize your mental performance, reduce stress, and decrease your risk of cognitive decline. But what makes a supplement a nootropic isn't clearly defined because theoretically, many vitamins and nutrients could help boost your brain health. For example, if you jumpstart your mornings with a cup of coffee, you're taking a nootropic because caffeine is considered one. And l-theanine—a compound in green tea that's known for improving mental focus—is a nootropic.

"Nootropics is kind of a made-up term. It's an arbitrary and imprecise term that people would say is a cognitive enhancer, but there are many cognitive enhancers," explains Richard S. Isaacson, MD, director of the Alzheimer's Prevention Clinic at New York-Presbyterian and Weill Cornell Medicine. "Caffeine can improve focus. Many people would argue that exercise is a cognitive enhancer. Nootropics just aren't scientific."

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When it comes to improving your cognitive function and reducing your risk of dementia and Alzheimer's, the reality is there isn't a one size fits all approach. Taking one supplement alone won't greatly improve their brain health.

"A lot of people are looking for a magic pill, but there's not one thing I recommend," Dr. Isaacson says. "If someone wants to improve their brain, we have to ask what is it exactly they want to improve. Cognition includes memory, attention, speed of processing, language, arousal."

Instead of focusing on taking a supplement that promises to improve your mental performance, Dr. Isaacson says to think about peeling back the layers on your lifestyle and ask yourself some questions: Am I getting enough sleep at night? Am I eating right? What am I doing to manage stress? The answers to these questions will help you and your doctor assess what you need to do to improve your cognitive function.

Popular nootropics and their uses

That said, if you're still considering taking a nootropic, keep in mind that many of the ones you see on the internet have a combination of compounds and adaptogenic herbs. Here's a breakdown of the most popular nootropic supplements:

  • Ashwagandha is a popular Ayurvedic adaptogen said to decrease stress and improve memory. There is some evidence that ashwagandha can also help reduce anxiety.
  • Bacopa monnieri extract, another Ayurvedic supplement, has been shown to improve memory and speed of recall. One review found that ginseng and bacopa monnieri were as effective as prescription modafinil.
  • Ginkgo biloba has been been touted to help improve cognitive function in people with dementia, but its claims aren't backed by enough research. In general, doctors and health experts don't recommend it for improving memory.
  • L-Theanine and caffeine, which are in green tea, may help improve focus and brain health long-term, but more human studies are needed to back their positive effects.
  • Creatine, which is best known as a protein powder, has been shown, along with other nutrients, to help improve cognitive function in older people.
  • Prevagen is an over-the-counter supplement that contains apoaequorin, which is a protein that proponents claim helps with mild memory loss and supports brain function. But its claims are unsubstantiated as an effective nootropic.
  • Omega-3 fatty acids, particularly DHA, has been shown to boost memory and reaction time in healthy young adults. Michael Lewis, MD, founder and president of the Brain Health Education and Research Institute and author of When Brains Collide explains that the modern diet tends to have an imbalance of inflammatory omega-6s compared to anti-inflammatory omega-3s. Consuming more omega-3s can help improve brain health by reducing inflammation.

Some examples of prescription nootropics include Donepezil and Ritalin (methylphenidate). But keep in mind that doctors give prescription nootropics only to people with cognitive impairments or disorders, like Alzheimer's or attention deficit hyperactivity disorder (ADHD, so if you think you might have an impairment, see your doctor.

It's hard to say because there's such a wide scope of what nootropics are, whether it's a supplement, a prescription drug—or even a cup of joe. Prescription nootropics, such as Donepezil, L-Deprenyl, Methylphenidate (Ritalin), Modafinil (Provigil), Piracetam, have been shown to be effective in boosting cognitive function. However, most of the research out there is focused on how these drugs can specifically help people with cognitive degeneration caused by Alzheimer's, Parkinson's, stroke or extreme stress—and not the average healthy person.

There's some promise on what natural nootropics can do, but more research is needed to back all its claims. According to a 2016 review in Evidence-based Complementary and Alternative Medicine, natural nootropics can help increase blood flow and oxygen to the brain. In addition, nootropics may also act as an antioxidant and reduce inflammation in the brain, says Shawn Wells, MPH, RD, FISSN, CISSN, BioTRUST Nutrition's chief science officer. But any compound that has anti-aging or antioxidant effects on the body will also help with brain health, Wells explains.

Just like buying other types of supplements and vitamins, purchasing nootropics on the internet has some risks because you don't know what you're getting exactly. Nootropic supplements aren't regulated by the Food & Drug Administration (FDA), so it's hard to tell what you're actually taking. For instance, a product can claim to have ashwagandha, but it might not actually contain it and may have other ingredients you didn't realize.

"Supplements can be also expensive and you can run the risk of taking too many leading to dangerous toxicity levels," says Abbey Sharp, RD, blogger at Abbey’s Kitchen, and author of the Mindful Glow Cookbook. The average bottle of nootropics runs upwards $40.

So if you're interested in taking nootropics, be sure to consult your doctor first. This way, they can recommend a certain supplement that will meet your specific cognitive needs. "You'll also be able to discuss with your doctor concerns about drug interactions and side effects," Wells says.

But even if your doctor is willing to prescribe medication or recommend supplements, you may want to consider other options, just as Dr. Isaacson recommends. "I think the first thing people should do is talk to their doctors about these drugs. In some cases, there are non-pharmacological strategies they can try before turning to medications," says Sharp. Consider the long-term effects of the drugs you may be prescribed before committing to a daily regimen and discuss concerns with your doctor.

The bottom line: There are safer, more effective ways to enhance and protect your brain health

While the idea of taking nootropics to enhance your cognitive performance sounds appealing, there's simply not enough science to back up their effectiveness in the average, healthy person.

"If you deem there is a problem or if you feel like your brain isn't working as well as it used to work, talk to a qualified medical professional," Dr. Isaacson says.

Instead, it's best to focus on following a lifestyle that promotes good brain health. "There is no substitute for the basics we were supposed to learn early in life: diet, exercise, and socialization," explains Dr. Lewis. "Study after study tells us that regular, intense exercise is good for the brain and helps us age better. There just isn’t anything better for brain health than increasing blood flow to the brain and that should be a daily occurrence." Doing regular physical activity delivers oxygen-carrying blood to the brain, boosting cognition and overall brain health.

Moreover, eating more whole foods can help reduce your risk of Alzheimer's disease. The MIND diet, which combines the Mediterranean diet and the DASH diet, has been shown to help slow cognitive decline. Much like the Mediterranean and DASH diets, the MIND diet emphasizes eating plenty of whole grains, leafy greens, nuts, beans, fatty fish, and healthy fats, like extra-virgin olive oil.

But perhaps the easiest way to improve your brain health is to seek the company of loved ones. Research has shown that people who have a support network of family and friends have a lower mortality risk than those who don't. It's thought that having more people in your inner circle can help you stay more physically active and give you the emotional support you need. "Get together with family and friends," says Dr. Lewis. "Laugh often, love much. Enjoy life."

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